Audience Research on Self-Management Education, Phase III

CDC and ATSDR Health Message Testing System

OMB: 0920-0572

IC ID: 213762

Information Collection (IC) Details

View Information Collection (IC)

Audience Research on Self-Management Education, Phase III 0920-15DC
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0572 Attachment 4 Screener_10282014 Attachment 4 Screener_10282014.docx Yes Yes Fillable Printable
Form and Instruction 0920-0572 Attachment 3 Mod Guide_10282014 Attachment 3 Mod Guide_10282014.docx Yes Yes Fillable Printable

Health Public Health Monitoring

 

160 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 160 0 0 0 0 160
Annual IC Time Burden (Hours) 134 0 0 0 0 134
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 1 Research Plan and Burden_10282014 Attachment 1 Research Plan and Burden_10282014.docx 11/10/2014
Attachment 2 Materials_v3 10282014 Attachment 2 Materials_v3 10282014.docx 11/10/2014
Attachment 5 Consent_10 27 Attachment 5 Consent_10 27.docx 11/10/2014
HMTS Expedited Review Form_SME 10282014 V3 HMTS Expedited Review Form_SME 10282014 V3.docx 11/10/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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